Active NPI
PDG, P.a.
Doing business as Facial Pain Center
- Dental Clinic/Center
- Burnsville, MN
National Provider Identifier
1821473927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Clinic/Center
- Legal business name
- PDG, P.A.
- Doing business as
- Facial Pain Center
- Practice address
- 40 W Nicollet Blvd
Burnsville, MN 55337 - Phone
- (952) 891-0222
- Fax
- (952) 891-0228
- NPI assigned
- Jul 30, 2015
- Last updated
- Oct 28, 2020
- Organization subpart
- Yes
- Parent organization
- PDG, P.A.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. John Gulon, DDS
- Title
- President
- Phone
- (651) 633-0500
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | Primary |
Addresses
Primary practice location
40 W Nicollet Blvd
Burnsville, MN 55337
Mailing address
2200 County Road C W
Suite 2210
Roseville, MN 55113-2550
Phone (651) 633-0500
Other names 1
- Facial Pain Center
National Provider Directory
National Provider Directory- Tax ID family
- Pdgpa
- Part of
- Pdgpa
Organizations with this tax ID in the same state 22
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438214400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1603843200000",
"number": "1821473927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 COUNTY ROAD C W",
"address_2": "SUITE 2210",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551132550",
"telephone_number": "651-633-0500",
"fax_number": "651-636-6350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 W NICOLLET BLVD",
"city": "BURNSVILLE",
"state": "MN",
"postal_code": "55337",
"telephone_number": "952-891-0222",
"fax_number": "952-891-0228"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PDG, P.A.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PDG, P.A.",
"enumeration_date": "2015-07-30",
"last_updated": "2020-10-28",
"certification_date": "2020-10-28",
"status": "A",
"authorized_official_last_name": "GULON",
"authorized_official_first_name": "JOHN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "651-633-0500",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "261QD0000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Dental",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Facial Pain Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Facial Pain Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Burnsville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.